Chronic sinus infections and/or allergies

I have been suffering from a bad sinus infection on and off for 6 months. I have seen 3 ENTs and had a CT scan and a MRI.

CT scan 2-2-08
findings: retention cysts are seen in annular recesses of maxillary sinuses dated mild mucosa thickening is present in sphenoid sinus. Rest of visualized paranasal sinuses are well aerated.
No evidence of air-fluid level. Concha bullosa is noted bilaterally.
Bilaterial ostiomeatal units are patent.
Visualized bilateral orbits appear grossly unremarkable.
impressions: Bilateral maxillary mucous retention cysts. Minimal mucosal thickening in sphenoid sinuses. There are no air-fluid levels to suggest acute sinusitis.

MRI 2-19-08
There is mucosal thickening along the inferior aspects of both maxillary sinuses. A mucous retention cyst is seen in the inferior portion of the left maxillary sinus measuring 1.6 x 1.2 cm. A smaller mucous retention cyst is seen in the inferior position of the right maxillary sinus measuring 1.6 x 0.6 cm. Following contrast, there is rim-enhancement of the mucous retention cyst with mild enhancement along the mucosa of the superior aspect of the maxillary sinuses. No disease is currently seen within the sphenoid sinus. Prior CT suggest some mucosal thickening which has apparently resolved.

Imaging of the included portion of the neck does show multiple lymph nodes which are not enlarged. There is a prominent right jugulodigastric lymph node measuring 12 x 10 mm. There is a prominent left jugulodigastric lymph node measuring 12 x 7 mm. There are numerous small lymph nodes seen along the posterior triangle and along the carotid chain with none measuring larger than 5mm in short axis. There are bilateral small nodules within both parotid glands which are probably lymph nodes. There is a preauricular lymph node on the left measuring 1.0 cm in size. The submandibular glands are normal. There are no orbital masses. The included portion of the brain parenchyma is normal.
There is no abnormality seen within the frontal nor ethmoid sinuses.

The 3rd ENT is thinking I have allergy issues and possibly atypical migraines? I am seeing an allergist soon and hope to find some answers soon. None of the ENTs have thought that any kind of sinus surgery would be beneficial to me.

Any thoughts or insights would be greatly appreciated.

[BhumikaMD]

Hi,

It would be advisable to consult an allergy specialist about your symptoms and also to talk to your ENT specialist again about having the mucus retention cysts removed which could be tha cause of your symptoms and also the enlarged lymph nodes.

What medications are you on currently? You could also talk to your doctor about ruling out an infective process in the sinuses which could be responsible for the enlarged lymph nodes.

You would need steroid nasal sprays, a course of antibiotic medications. Have you tried steam inhalation, antihistamine medications and saline nasal drops? Have they helped?

Let us know what the allergy specialist advises and also if you have any doubts.

Hope this helps.

Good luck.

[angelainwi]

Found out I am very allergic to dust mites and both the ENT and the allergist I was able to get into to see today think I might also be experiencing atypical migraines.

I am gonna do the encasing of bedding and such and also steroid nasal sprays.

Wish me luck. She doesn't think taking the cysts out right now will help.

The ENT prescribed some kind of antibiotic for 3 weeks.

[BhumikaMD]

Hi,

It would definitely help to continue with the current plan of treatment and your symptoms should start to respond soon.

Get a review with your specialist in some days if required and also if your symptoms persist or worsen.

You could simultaneously try steam inhalation, saline nasal drops and breathing exercises.

Please let us know how you are doing and if you have any other doubts.

Regards.

[cjsgma]

I have had what was told a cyst for several years right beside my nose (interior) Feels like it is in my sinuses.  It kinda felt like a BB.  Just recently it has started growing now it about the size of a quarter but not quite round. It is starting to block my air through that side of my nose.  My Dr had said when it was small not to worry about it.  ShouldI worry now? Thank you.